Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A172167 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A172167 | CA |
NPI | 1306200662 |
---|---|
Provider Name | Mina Zarei |
First Address | San Jose, CA 95119-1215 |
Second Address | Brea, CA 92821-5726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 12/07/2021 |